How widely used are airway clearance techniques for bronchiectasis?

A summary of research published in the European Respiratory Journal

People living with bronchiectasis are encouraged to regularly clear their airways as part of their treatment plan. This is a recommended step in international guidelines. However, it is not known whether this treatment option is widely used and what affects people’s decision to use it.


Bronchiectasis is a long-term lung condition where the airways of the lungs get damaged and widen. This makes it difficult to clear mucus (sputum) out of the lungs, which can make the lungs more at risk of getting infections.

Recommended management of bronchiectasis involves exercises to clear the airways. These are known as airway clearance techniques. They are ideally supported by a specialist physiotherapist. They work by loosening thick mucus so it can be cleared from the lungs by coughing. Common practices include:

  • Breathing exercises to open the airways;
  • Practices that involve positioning the body in specific ways to drain mucus from the airways using gravity.

Find out more about airway clearance techniques on our bronchiectasis page on the information hub. Some people also use drugs that help to clear mucus or medical devices such as positive expiratory pressure (PEP) devices and percussive vests, which break up mucus in the lungs.

What did the study look at?

This study used information collected from the European bronchiectasis registry (EMBARC), a database of people with bronchiectasis in Europe and Israel. The study looked at the use of airway clearance practices, drugs and medical devices in adults from 28 countries. It collected information on who used airway clearance techniques and why people choose certain treatment options.

What do the results show?

The study found large differences in which practices were being used.  Results showed that the choice of practices was based on habit rather than evidence.

Only half of people studied used regular airway clearance practices to help clear their airways. This may be because of limited access to specialist physiotherapists, airway clearance devices, and medication.

Researchers found that the people who were most likely to use regular airway clearance practices were women with severe bronchiectasis who were non-smokers. This group of people also had a poor quality of life due to difficulty breathing and were more likely to use medication.

Why is this important?

This study sheds light on who is using airway clearance techniques. It found that mainly people with severe bronchiectasis were likely to use them. However, the authors believe that people with milder symptoms could also benefit. This could lead to fewer lung infections, less antibiotic use, and an overall improvement in health and wellbeing. Further research is needed to find out the best methods of airway clearance for each individual.

Read the original research paper:

Airway clearance management in people with bronchiectasis: data from the European Bronchiectasis Registry (EMBARC)